A Systematic Review and Meta-Analysis Examining the Risk of Adverse Pregnancy and Neonatal Outcomes in Women with Isolated Hypothyroxinemia in Pregnancy

Han, Yutong; Gao, Xiangjing; Wang, Xichang; Zhang, Chenyu; Gong, Boshen; Peng, Bingcong; Li, Jiashu; Liu, Aihua; Shan, Zhongyan

doi:10.1089/thy.2022.0600

Cited by 9 publications

(5 citation statements)

References 49 publications

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“…After adjusting for confounding factors such as age, BMI, parity, abnormal pregnancy history, FPG, and TC, the relationship remained statistically significant (adjusted OR: 2.32, 95% CI: 1.13-4.75, P = 0.022). These results were consistent with those of previous studies (10,16). Furthermore, our results indicated an increasing trend in the risk of macrosomia with IH severity (crude P trend = 0.000; adjusted P trend = 0.002).…”

Section: Discussionsupporting

confidence: 93%

“…IH is a common form of thyroid dysfunction observed in the pregnant population (16). Previous studies have reported a wide range in the incidence rate of IH in pregnant women, ranging from 1.3% to 23.9% (17), with the most commonly reported rates being 8-10% (18).…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with our study, where we found no significant association between IH in the first trimester and GDM, HDP, spontaneous abortion, PROM, placental abruption, oligohydramnios, premature delivery, fetal distress, or low birth weight. However, some meta-analyses (10,16) have reported a significantly increased risk of GDM, PROM, preterm birth, and fetal distress in pregnant women with IH compared to that in women with euthyroidism. These discrepancies could be attributed to differences in the study population, including ethnicity and gestational age, and variations in thyroid function testing methods and diagnostic criteria.…”

Section: Discussionmentioning

confidence: 99%

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Maternal isolated hypothyroxinemia in the first trimester is not associated with adverse pregnancy outcomes, except for macrosomia: a prospective cohort study in China

Du,

Ji,

Zhang

et al. 2023

Front. Endocrinol.

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ObjectiveInsufficient thyroid hormone levels during pregnancy, especially in the first trimester, adversely affect maternal and fetal health. However, the impact of isolated hypothyroxinemia (IH) on adverse pregnancy outcomes remains controversial. Therefore, this study aimed to investigate the association between IH during the first trimester and adverse pregnancy outcomes.MethodsThis prospective cohort study included 1236 pregnant women. Thyroid-stimulating hormone and free thyroxine levels were measured before 13 weeks of gestation. Logistic regression analysis and the Cochran-Armitage trend test were used to assess the association between IH in the first trimester and adverse pregnancy outcomes.ResultsIH during the first trimester was associated with an increased risk of macrosomia. After adjusting for confounding factors, including age, body mass index, parity, abnormal pregnancy history, fasting blood glucose, and total cholesterol, multivariate logistic regression analysis showed that IH in the first trimester remained an independent risk factor for macrosomia. In addition, the risk of macrosomia increased with IH severity. However, no significant relationship was found between IH during the first trimester and gestational diabetes mellitus, hypertensive disorders of pregnancy, spontaneous abortion, premature rupture of membranes, placental abruption, oligohydramnios, premature delivery, fetal distress, or low birth weight.ConclusionIH during the first trimester did not increase the risk of adverse pregnancy outcomes, except for macrosomia.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Maternal isolated hypothyroxinemia in the first trimester is not associated with adverse pregnancy outcomes, except for macrosomia: a prospective cohort study in China

Du,

Ji,

Zhang

et al. 2023

Front. Endocrinol.

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“…FT4 in the normal range of pregnant women is negatively related to the weight of the newborn, and the relationship between FT4 and birth weight is more obvious in the middle and late pregnancy than in the early pregnancy [ 17 ]. A recent meta-study shows that [ 18 ], compared with euthyroid precursors, isolated hyperoxinamia (IH) precursors were associated with an increased risk of macrosomia (RR 1.62 [CI 1.31–2.02]; I 2 = 42%).…”

Section: Discussionmentioning

confidence: 99%

Relationship between the Central and Peripheral Thyroid Sensitivity Indices and Fetal Macrosomia: A Cohort Study of Euthyroid Pregnant Women in China

et al. 2023

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(1) Background: To explore the correlation between central and peripheral thyroid sensitivity indices and macrosomia in euthyroid pregnant women and to provide clinical basis for the prevention and treatment of macrosomia. (2) Methods: This study is a prospective study. A total of 1176 euthyroid women in early pregnancy in the obstetrics department of Peking University International Hospital from December 2017 to March 2019 were enrolled. The women were divided into two groups, namely the macrosomia and non-macrosomia groups, according to birth weight. (3) Results: The level of free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid feedback quantile-based index (TFQI), thyrotropin-T4 resistance index (TT4RI), thyroid-stimulating hormone index (TSHI), and free triiodothyronine/free thyroxine (FT3/FT4) in the macrosomia group was higher than that in the non-macrosomia group (p < 0.05). The multivariate logistic regression model showed that FT3, TFQI, TT4RI, TSHI, and FT3/FT4 were independent risk factors for macrosomia in early pregnancy after adjusting for age, body mass index, parity, blood pressure, blood glucose, and blood lipid levels (p < 0.05, respectively). (4) Conclusions: TFQI, TT4RI, TSHI, and FT3/FT4 are independent risk factors for fetal macrosomia in early pregnancy in euthyroid women.

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“…The most common thyroid disorder is subclinical hypothyroidism which often goes undiagnosed during pregnancy without screening 2–4 . Hypothyroidism is associated with spontaneous abortion, pre‐eclampsia, premature delivery, low birth weight, intrauterine growth retardation, and high perinatal mortality during pregnancy 5 . There have also been reports of neonatal hyperbilirubinemia, neonatal hypo/hyperthyroidism, attention deficit disorder and hyperactivity syndrome in these children 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of thyroid dysfunction during first trimester of pregnancy: A descriptive cross‐sectional study

Sharma,

Gurung,

Katuwal

et al. 2023

Repro Female Child Health

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ObjectivesThyroid dysfunction carries large burden during pregnancy and untreated thyroid dysfunction is associated with poor maternal and foetal outcome. The exact burden of thyroid dysfunction during pregnancy in Nepal is not well established. This is descriptive cross‐sectional study done in tertiary care centre of Nepal to know burden of thyroid dysfunction and establish possible need of universal thyroid function screening during pregnancy.MethodsA descriptive cross‐sectional study was conducted from 4 September 2020 to 3 September 2021 on pregnant women attending to ANC clinic during their first trimester after obtaining ethical approval. Among eligible patients, after taking informed consent, a total of 385 pregnant women were included in the study. Thyroid function status was assessed by measuring serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri‐iodothyronine (FT3). Women with pre‐existing thyroid disorders were excluded. Serum thyroid function was used to detect thyroid disorder based on American Thyroid Association 2011 criteria. A convenience sampling method was used. Point estimate and 95% confidence interval (CI) were calculated.ResultsAmong 385 pregnant women, 152 (39.48%) (39.20–39.70, 95% CI) had thyroid disorders. Among thyroid disorders (n = 152), 111 (28.83%) had subclinical hypothyroidism, 37 (9.61%) overt hypothyroidism, 3 (0.78%) subclinical hyperthyroidism and 1 (0.26%) had overt hyperthyroidism.ConclusionAround four in every 10 pregnant women had thyroid disorder. Thyroid dysfunction is easily detectable and can be effectively, inexpensively treated, which can prevent adverse maternal and foetal outcome. Thus, we should consider universal screening of pregnant women for thyroid disorder especially in a country like Nepal where there is a high prevalence of undiagnosed thyroid disorder.

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A Systematic Review and Meta-Analysis Examining the Risk of Adverse Pregnancy and Neonatal Outcomes in Women with Isolated Hypothyroxinemia in Pregnancy

Cited by 9 publications

References 49 publications

Maternal isolated hypothyroxinemia in the first trimester is not associated with adverse pregnancy outcomes, except for macrosomia: a prospective cohort study in China

Maternal isolated hypothyroxinemia in the first trimester is not associated with adverse pregnancy outcomes, except for macrosomia: a prospective cohort study in China

Relationship between the Central and Peripheral Thyroid Sensitivity Indices and Fetal Macrosomia: A Cohort Study of Euthyroid Pregnant Women in China

Prevalence of thyroid dysfunction during first trimester of pregnancy: A descriptive cross‐sectional study

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